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REVASK SURGERY CENTER LLC
NPI 1396238010
Clinic/Center - Ambulatory Surgical in Wichita, KS

Active since June 07, 2018CLIA 17D2160355 · Waiver
2122 N GARNETT ST, WICHITA, KS 67206(316) 636-1234(316) 636-2630 Get Directions Write a Review

NPPES record last updated: March 29, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 29, 2021, Oct 16, 2018 (2 updates tracked since 2018).

About Revask Surgery Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVASK SURGERY CENTER LLC (NPI 1396238010) is a healthcare organization registered as an ambulatory surgical in Wichita, Kansas and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through January 8, 2027 and lists Wissam Saliba, Director, as its authorized official.

NPPES Registry Identity

NPI1396238010
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameWICHITA NEPHROLOGY GROUP, PA
Location Address2122 N GARNETT STWichita, KS 67206-3023
Mailing Address2122 N Garnett StWichita, KS 67206-3023 · (316) 263-5891 · Fax (316) 263-3083
Phone(316) 636-1234
Fax(316) 636-2630
Organization SubpartYes
Authorized OfficialWissam SalibaDirector · (316) 263-5891
Enumeration DateJune 7, 2018
Last NPPES UpdateMarch 29, 20212 updates tracked since enumeration
NPPES CertifiedMarch 29, 2021
✔ NPI 1396238010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in KS · 04-35548
2122 N GARNETT ST, Wichita, KS 67206
Open in Google Maps ↗

Other Names 1

Doing Business AsRevask Surgery Center Llc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revask Surgery Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

13

Medicare enrollment records show 13 clinicians reassign Medicare billing to Revask Surgery Center LLC, which bills Medicare for the services they deliver. Of these, 13 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Nephrology8
Internal Medicine2
Nurse Practitioner2
Registered Dietitian or Nutrition Professional1

Clinicians, nearest first (13)

Ronnie Moussa, MD
Nephrology
NPI 1437316387
818 N EMPORIA ST SUITE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare7.9 mi
Amanda Valliant, MD
Internal Medicine
NPI 1609004316
818 N EMPORIA ST SUITE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare7.9 mi
Edgard Wehbe, MD
Nephrology
NPI 1851513287
818 N EMPORIA ST SUITE310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare7.9 mi
Sarah Wolfe, RDN
Registered Dietitian or Nutrition Professional
NPI 1548183387
818 N EMPORIA ST STE 310
Wichita, KS 67214
(316) 494-4912
7.9 mi
Ushasri Challa, M.D.
Nephrology
NPI 1992756563
818 N EMPORIA ST SUITE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS8.0 mi
Michael Grant, M.D.
Nephrology
NPI 1316990781
818 N EMPORIA ST SUITE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare8.0 mi
Joseph Meouchy, MD
Nephrology
NPI 1922396894
818 N EMPORIA ST STE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare8.0 mi
Erica Roach, APRN
Nurse Practitioner
NPI 1386282655
818 N EMPORIA ST STE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare8.0 mi
Wissam Saliba, MD
Nephrology
NPI 1104025949
818 N EMPORIA ST STE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare8.0 mi
Mohamad Sandid, M.D.
Nephrology
NPI 1992778518
818 N EMPORIA ST SUITE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare8.0 mi
Levi Short, MD
Internal Medicine
NPI 1790198448
818 N EMPORIA ST STE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare8.0 mi
Tracy Smith, APRN
Nurse Practitioner
NPI 1053727800
818 N EMPORIA ST SUITE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare8.0 mi
Jany Moussa, M.D.
Nephrology
NPI 1861443459
818 N EMPORIA ST SUITE 310
Wichita, KS 67214
(316) 263-5891
✔ PECOS✔ Accepts Medicare8.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 17D2160355

Revask Surgery Center, LLC · Wichita, KS
Active · expires Jan 8, 2027
CLIA Number17D2160355
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJanuary 9, 2025
Certificate Expiration DateJanuary 8, 2027
Laboratory DirectorWissam Saliba
Laboratory Phone(316) 636-1234
Laboratory LocationRevask Surgery Center, LLC2122 N Garnett Street, Wichita, KS 67206
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist 36902
This procedure involves inserting a needle or tube into your hemodialysis circuit, a system that cleans your blood when your kidneys can't. A balloon is then used to widen a narrow section of this circuit. A radiologist reviews the procedure to ensure accuracy.
267 services160 patients
Insertion of needle and/or tube into hemodialysis circuit with review by radiologist 36901
This procedure involves inserting a needle or tube into your hemodialysis circuit, which is part of the system that cleans your blood when your kidneys can't. A radiologist, a doctor specialized in imaging techniques, will review the process to ensure everything is correct.
70 services56 patients
Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access 93985
This procedure involves using ultrasound technology to examine the blood flow in your arteries and veins on both sides of your body. It's crucial for preparing for hemodialysis access, ensuring safe and effective treatment.
66 services66 patients
Review by radiologist of both arms and legs veins of both arms or legs image 75822
This procedure involves a radiologist examining images of veins in your arms and legs. These images can help identify any abnormalities or issues with blood flow. The process is non-invasive and painless, providing valuable information for your healthcare.
63 services63 patients
Removal of tunneled central venous tube 36589
A tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.
57 services53 patients
Replacement of tunneled central venous tube 36581
A tunneled central venous tube replacement is a procedure where an existing tube, used to deliver medication or nutrition directly to a large vein, is replaced. This is done under local anesthesia and involves inserting a new tube through a small incision.
52 services36 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wichita Nephrology Group, PA's NPI number?

The NPI number for Wichita Nephrology Group, PA is 1396238010. It was assigned to this organization in the NPPES registry on June 7, 2018. The provider is doing business as Revask Surgery Center LLC.

Where is Wichita Nephrology Group, PA located?

Wichita Nephrology Group, PA is located at 2122 N Garnett St, Wichita, KS 67206. The listed phone number is (316) 636-1234.

What is Wichita Nephrology Group, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Is Wichita Nephrology Group, PA enrolled in Medicare?

Yes. Wichita Nephrology Group, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wichita Nephrology Group, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 4 Medicare specialties reassign their Medicare billing to Wichita Nephrology Group, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nephrology (8), Internal Medicine (2) and Nurse Practitioner (2). Of these, 13 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Wichita Nephrology Group, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 17D2160355) is associated with this NPI, valid through January 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wichita Nephrology Group, PA accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Ambetter of Oklahoma and Blue Cross and Blue Shield of Kansas, Inc. and 1 other insurer list Wichita Nephrology Group, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wichita Nephrology Group, PA was last updated on March 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.